In physicians’ constant battle between life and death, where life is often viewed as victory… In physicians’ constant battle between life and death, where life is often viewed as victory and death as defeat, more attention is being focused on end-of-life care for terminally ill patients.

Last Thursday at Pitt’s School of Medicine, Dr. Edward Lowenstein confronted the issues of physician-assisted suicide (PAS) and euthanasia. His lecture, titled “Ethics, Physicians, and Relief of Intolerable Suffering: Lessons from the Oregon Death with Dignity Act,” was part of the 24th Peter and Eva Safar Annual Lectureship in Medical Sciences and Humanities.

According to the International Task Force Web site on Euthanasia, it is the act of killing that differentiates the use of euthanasia from PAS. In PAS, it is the patient that ultimately ends her life by taking medication intended for ending life.

While the use of euthanasia also leads to the death of the patient, someone other than the patient ultimately ends the life of the patient.

During his speech, Dr. Lowenstein – a professor at Harvard’s School of Medicine – made many references to the Oregon Death with Dignity Act, which was passed by the state of Oregon in 1997. This law makes PAS a legal practice for physicians in the state of Oregon. The law only pertains to Oregon residents and allows patients to be in control of the whole process, he said.

The patients in PAS are the decision-makers in the process of ending their lives and, eventually, the administrators of the medication.

Oregon’s law has been scrutinized since its approval, according to Lowenstein. Though the United States Supreme Court refused to hear a case brought against the state law, cases are still challenging the law in courts.

Opponents of the law say it would target special groups, such as people who are uneducated and people who are poor, Lowenstein said. But Dr. Lowenstein noted indications of the opposite trend in the annual report of Oregon’s Death with Dignity Act. College graduates were more likely to use PAS than non-college graduates, and statistics showed that more men than women used PAS.

Oregon is the only state that permits PAS, and the Netherlands and Belgium are the only countries in the world that have legalized PAS, along with euthanasia. Dr. Lowenstein said he has become dedicated to focusing on the care of terminally ill patients. He supports the state of Oregon in legalizing PAS and encourages more legislation to be passed to allow the practice PAS in the United States.

The Death with Dignity Act passed by Oregon has provided an alternative for patients who experience pain and suffering, thereby setting the stage for reform in patient care for the terminally ill, he said.